Clip applier

ABSTRACT

A clip applier may be configured to apply a surgical clip. The clip applier may include a first jaw member and a second jaw member, where the first jaw member is configured to pivot between an open configuration and a closed configuration. The clip applier may also include a first leaf spring configured to bias the first jaw member into the open configuration, and a tubular member configured to advance over the first jaw member to cam the first jaw member into a closed configuration against the bias of the first leaf spring. The clip applier may further include a second leaf spring configured to bias the second jaw member into the open configuration, and a tubular member configured to advance over the second jaw member to cam the second jaw member into a closed configuration against the bias of the second leaf spring.

PRIORITY

This application is a continuation of International Patent ApplicationPCT/US2020/052746 (filed Sep. 25, 2020), which claims the benefit ofpriority of U.S. Provisional Patent Application No. 62/906,585 (filedSep. 26, 2019 and now expired), the disclosures of which are expresslyincorporated herein by reference in their entirety.

TECHNICAL FIELD

The present disclosure relates generally to clip appliers, and moreparticularly, to clip appliers with improved actuation mechanisms and/orstabilizing members configured to stabilize a surgical clip.

BACKGROUND

Ligation of tissue (e.g., blood vessels, lymph nodes, nerves, fallopiantubes, and cardiac tissue) is a common practice for many surgicalprocedures. This can be performed by closing the vessel with a surgicalclip or by suturing the vessel with the surgical thread. The use ofsurgical thread requires complex manipulations of a needle and surgicalthread to form knots required to secure the vessel. Such complexmanipulations are time consuming and difficult to perform, particularlyin endoscopic surgical procedures characterized by limited space and/orvisibility. In contrast, surgical clips are relatively quick and easy toapply. Accordingly, the use of surgical clips in endoscopic and opensurgical procedures has grown dramatically.

SUMMARY

The present inventor recognizes that there is a need to improve one ormore features of the clip appliers, such as stability of the surgicalclip in a clip applier and/or ease of actuation. Surgical clips areoften applied by clip appliers with a pair of opposing jaws. Currentlyavailable clip appliers often secure the clip with two points ofcontact, for example, the opposing jaws may engage bosses on distal endsof the surgical clip. However, the two points of contact do not providesufficient stability to the surgical clip, which may cause the surgicalclip to become misaligned relative to the clip applier during a surgicalprocedure, or even fall out. Furthermore, current clip appliers often donot provide sufficient closing force and/or reliable opening of thejaws. The disclosed methods and systems are directed to mitigating orovercoming one or more of the problems set forth above and/or otherproblems in the prior art.

A first aspect of the present invention is directed to a clip applierconfigured to apply a surgical clip. The clip applier may include afirst jaw member and a second jaw member. The first jaw member mayinclude a first inner surface and a first stabilizing member extendingfrom the first inner surface, and may be configured to engage a distalportion of a first leg member of the surgical clip. The second jawmember may include a second inner surface and a second stabilizingmember extending from the second inner surface. The second jaw membermay be configured to engage a distal portion of a second leg member ofthe surgical clip. The first stabilizing member and the secondstabilizing member may be configured to be positioned on oppositelateral sides of a proximal portion of the surgical clip to reducelateral movement of the surgical clip.

A second aspect of the present invention is directed to an assemblyincluding a surgical clip having a first leg member and a second legmember, and a clip applier. The clip applier may include a first jawmember and a second jaw member. The first jaw member may include a firstinner surface and a first stabilizing member extending from the firstinner surface, and may be configured to engage a distal portion of thefirst leg member of the surgical clip. The second jaw member may includea second inner surface and a second stabilizing member extending fromthe second inner surface. The second jaw member may be configured toengage a distal portion of the second leg member of the surgical clip.The first stabilizing member and the second stabilizing member may beconfigured to be positioned on opposite lateral sides of a proximalportion of the surgical clip to reduce lateral movement of the surgicalclip.

In some embodiments, an inner portion of the first stabilizing member isspaced apart from the second jaw member in an open configuration, and aninner portion of the second stabilizing member is spaced apart from thefirst jaw member in the open configuration. In some embodiments, thefirst jaw member has a first channel in the first inner surface, and thesecond jaw member has a second channel in the second inner surface,where the first channel does not receive the second stabilizing memberin the open configuration, the first channel receives the secondstabilizing member in a closed configuration, the second channel doesnot receive the first stabilizing member in the open configuration, andthe second channel receives the first stabilizing member in the closedconfiguration. In some embodiments, the first channel has a widenedproximal portion configured to receive the second stabilizing member,and the second channel has a widened proximal portion configured toreceive the first stabilizing member. In some embodiments, the firststabilizing member includes a first wall extending longitudinally alongthe first inner surface, the second stabilizing member includes a secondwall longitudinally extending along the second inner surface, and thefirst wall and the second wall are disposed on opposite lateral sides ofa longitudinal axis of the clip applier. In some embodiments, each ofthe first stabilizing member and the second stabilizing member has atleast one substantially flat lateral surface. In some embodiments, thefirst stabilizing member and the second stabilizing member extendsubstantially parallel in the open configuration and the closedconfiguration. In some embodiments, the first stabilizing member and thesecond stabilizing member laterally overlap in the closed configuration.In some embodiments, the first stabilizing member and the secondstabilizing member do not laterally overlap in the open configuration.In some embodiments, each of the first stabilizing member and the secondstabilizing member has an inner portion defining an apex extendingdistally in the open configuration. In some embodiments, the first innersurface has at least one first recess on a distal portion configured toreceive a first boss on the first leg member of the surgical clip, andthe second inner surface has at least one second recess on a distalportion configured to receive a second boss on the second leg member ofthe surgical clip. In some embodiments, the first stabilizing member isintegral to the first jaw member, and the second stabilizing member isintegral to the second jaw member. In some embodiments, the firststabilizing member and the second stabilizing member are configured tonot proximally contact a proximal end of the surgical clip in the openconfiguration.

A third aspect of the invention is directed to a clip applier configuredto apply a surgical clip. The clip applier may include a first jawmember and a second jaw member, where the first jaw member is configuredto pivot between an open configuration and a closed configuration. Theclip applier may also include a leaf spring configured to bias the firstjaw member into the open configuration, and a tubular member configuredto advance over the first jaw member to cam the first jaw member into aclosed configuration against the bias of the leaf spring.

In some embodiments, the clip applier has a second leaf springconfigured to bias the second jaw member into an open configuration,where the second jaw member is configured to pivot between the openconfiguration and the closed configuration, and the tubular member isconfigured to advance over the second jaw member to cam the second jawmember into the closed configuration against the bias of the second leafspring. In some embodiments, the leaf spring overlaps with a proximalportion of the first jaw member to bias the first jaw member into theopen configuration, and the second leaf spring overlaps with a proximalportion of the second jaw member to bias the second jaw member into theopen configuration. In some embodiments, the proximal portion of each ofthe first and second jaw members includes a proximal extension angledrelative to a longitudinal axis of the clip applier. In someembodiments, the proximal extension extends from only one lateral sideof the respective first and second jaw member. In some embodiments, thefirst jaw member and the second jaw member each has a proximal portionand a distal portion, the proximal portion having a width less than thedistal portion and configured to be received in the tubular member. Insome embodiments, the clip applier has a connector disposed in thetubular member, where the leaf spring and the second leaf spring aredisposed on opposite lateral sides of the connector. In someembodiments, a proximal portion of the leaf spring and a proximalportion of the second leaf spring are fixed to the connector. In someembodiments, at least one of the first jaw member and the second jawmember is pivotably coupled to the connector. In some embodiments, thefirst jaw member is pivotably coupled to the connector at a first pivotpin, and the second jaw member is pivotably coupled to the connector ata second pivot pin. In some embodiments, the proximal portion of atleast one of the first jaw member and the second jaw member straddles adistal portion of the connector. In some embodiments, the tubular memberincludes a distal portion and a proximal portion, the distal portionhaving a larger diameter than the proximal portion, where the distalportion is configured to cam the first jaw member and second jaw memberinto the closed configuration. In some embodiments, the connector has apin, the tubular member has an elongated slot, where the pin travelsthrough the elongated slot as the tubular member advances. In someembodiments, the pin of the connector is fixed to a shaft receiving thetubular member. In some embodiments, the clip applier includes a shaft,a handle assembly on a proximal end of the shaft, and an actuatorextending through the shaft and actuated by the handle assembly, wherethe actuator is configured to advance through the shaft to advance thetubular member over the first jaw member and the second jaw member.

BRIEF DESCRIPTION OF THE DRAWINGS

In order that the disclosure may be readily understood, aspects of thisdisclosure are illustrated by way of examples in the accompanyingdrawings.

FIG. 1 illustrates an exemplary embodiment of a clip applier of thepresent disclosure.

FIG. 2 illustrates a perspective view of a distal end effector of theclip applier of FIG. 1.

FIG. 3 illustrates a frontal view of the distal end effector of FIG. 2.

FIG. 4 illustrates a side view of the distal end effector of FIGS. 2-3loaded with an exemplary surgical clip.

FIG. 5 illustrates a perspective view of the distal end effector ofFIGS. 2-4 loaded with the exemplary surgical clip.

FIG. 6 illustrates a side view of the clip applier of FIGS. 1-5 in anopen configuration.

FIG. 7 illustrates a side view of the clip applier of FIGS. 1-6 in aclosed configuration.

FIG. 8 illustrates a top view of the clip applier of FIGS. 1-7 in theclosed configuration with an overtube removed.

FIG. 9 illustrates a side view of the clip applier of FIGS. 1-8 in theclosed configuration with a shaft removed.

The same or similar reference numbers are used in the drawings and thefollowing detailed description to refer to the same or similar parts.

DETAILED DESCRIPTION

The invention will now be described with reference to the figures, inwhich like reference numerals refer to like parts throughout. Inaccordance with conventional practice, as used herein, and unlessotherwise indicated herein, the term “proximal” refers to the relativepositioning of a clip applier or component generally closer to a user ormedical personnel handling or manipulating the device as it is intendedto be used, and the term “distal” refers to the relative positioning ofthe clip applier or component further from the user or medical personnelhandling or manipulating the device as it is intended to be used. Theterm “vertical” refers to a relative direction of the clip applierparallel or along a plane extending evenly through both jaw members orsimilarly to the component. The term “longitudinal” refers to a relativedirection along a long axis or length of the clip applier or component.The term “lateral” refers to a relative direction parallel to or along aplane extending perpendicularly between the first and second jaw membersor similarly to the component.

FIG. 1 illustrates an exemplary clip applier 100 having a jaw assembly102, a shaft 104, and a handle assembly 106. The jaw assembly 102 mayinclude a first jaw member 110 and a second jaw member 112 pivotablycoupled at a distal portion of the shaft 104 and actuatable bylongitudinal movement of an overtube or tubular member 114. Movement ofthe tubular member 114 may be caused by relative movement of a firsthandle member 116 and a second handle member 118. For example, the firsthandle member 116 may be fixed and the second handle member 118 may bepivotably moveable at a pivot pin, such that pivoting of the secondhandle member 118 relative to the first handle member 116 may causelongitudinal advancement of the tubular member 114. The tubular member114 may include camming surfaces at the distal end of the tubular member114 that cam the first and second jaw members 110, 112 into a closedconfiguration. The clip applier 100 may be a manual clip applier, whicha user or medical personnel front-loads surgical clips 50 individuallyinto the jaw assembly 102 from a clip cartridge (not shown) and applieseach of the surgical clips 50 individually to tissue after each loading.Further disclosure of the manual loading of the clip applier 100 may befound in U.S. Pat. No. 6,880,699, the entire disclosure of which isincorporated herein by reference in its entirety.

FIG. 2 illustrates a first perspective view of an exemplary embodimentof the jaw assembly 102 of the clip applier 100, and FIG. 3 illustratesa frontal view of the jaw assembly 102. FIG. 4 illustrates a side viewof the jaw assembly 102 loaded with a surgical clip 50, and FIG. 5illustrates a perspective view of the jaw assembly 102 loaded with thesurgical clip 50. FIG. 6 illustrates a side view of the clip applier 100in an open configuration, and FIG. 7 illustrates a side view of the clipapplier 100 in the closed configuration. FIG. 8 illustrates atop view ofthe clip applier 100 in the closed configuration with the tubular member114 removed for clarity purposes. FIG. 9 illustrates a side view of theclip applier 100 in the closed configuration with the shaft 104 removedfor clarity purposes.

As illustrated in FIGS. 2-3, the first jaw member 110 may include afirst inner surface 120 having a first longitudinal channel 122, one ormore recesses 124 on a distal portion, and a stabilizing member 126 on aproximal portion. The second jaw member 112 may include a second innersurface 130 having a second longitudinal channel 132, one or morerecesses 134 on a distal portion, and a stabilizing member 136 on aproximal portion. The recesses 124, 134 may be substantiallysemi-circular grooves at the distal portions of the jaw members 110,112. The stabilizing members 126, 136 may be integral to the respectivejaw member 110, 112. The stabilizing members 126, 136 may besubstantially rigid and extend substantially parallel to a longitudinalaxis of the jaw members 110, 112 in the open and closed configurations,and create a longitudinal space therebetween. The first stabilizingmember 126 may include a first wall projecting from the first innersurface 120 and extending longitudinally along the first inner surface120, the second stabilizing member 136 may include a second wallprojecting from the second inner surface 130 and extending along thesecond inner surface 130. The first and second walls 126, 136 may be finshaped, including a concave and/or angled distal surface and a convexand/or angled proximal surface, each relative to the inner surface 120,130 to define a distally-facing apex at an inner portion 128, 138. Theinner portion 128, 138 may extend distally in the open configuration, asillustrated in FIG. 4. The first and second jaw members 110, 112 may berotationally symmetric, such that the first and second stabilizingmembers 126, 136 may be disposed on opposite lateral sides of alongitudinal axis of the clip applier. The surgical clip 50 may bereceived along the longitudinal axis of the clip applier, thus thestabilizing members 126, 136 may be positioned on opposite sides of aproximal portion of the surgical clip 50.

The stabilizing members 126, 136 may or may not laterally overlap eachother in the open configuration (e.g., FIGS. 1-6), and the stabilizingmembers 126, 136 may laterally overlap each other in the closedconfiguration (e.g., FIG. 7). The first inner portion 128 may be spacedapart from the second jaw member 112 and not be received in the secondlongitudinal channel 132 in the open configuration (e.g., FIGS. 2-6).The first inner portion 128 may be received in the second longitudinalchannel 132 in the closed configuration (e.g., FIG. 7). Similarly, thesecond inner portion 138 may be spaced apart from the first jaw member110 and not be received in the first longitudinal channel 122 in theopen configuration (e.g., FIG. 2-6). The second inner portion 138 may bereceived in the first longitudinal channel 122 in the closedconfiguration, and the second inner portion 138 may be received in thefirst longitudinal channel 122 in the closed configuration (e.g., FIG.7). For example, as further illustrated in FIG. 3, the firstlongitudinal channel 122 may include a widened proximal portion 123configured to receive the second stabilizing member 136, and the secondlongitudinal channel 132 may include a widened proximal portion 133 toreceive the first stabilizing member 126. The widened proximal portions123, 133 may be lateral, off-axis relative to the longitudinal axis ofthe clip applier 100, such that the longitudinal channels are asymmetricrelative to the longitudinal axis. The stabilizing members 126, 136 mayeach include at least one lateral flat surface to facilitate insertioninto the respective longitudinal channel 122, 132 and/or provide lateralstability of the surgical clip 50. For example, the stabilizing members126, 136 may each include a flat laterally exterior surface to slidealong a flat interior side surface of the widened proximal portions 123,133. The first longitudinal channel 122 and/or second longitudinalchannel 132 may also receive a portion of the surgical 50 in the openconfiguration (as illustrated in FIG. 4) and/or closed configuration.

As illustrated in FIGS. 4-5, the jaw assembly 102 may be configured tohold the surgical clip 50 with at least three points of contact. Thesurgical clip 50 may include a first leg member 52 and a second legmember 54 having proximal ends pivotably joined at a hinge portion 56.The surgical clip 50 may include one or more bosses 58 at a distalportion of each of the first and second leg members 52, 54. The bosses58 may be circular corresponding to the recesses 124, 134 and bereleasably received in the recesses 124, 134 to secure the distalportion of the surgical clip 50. Furthermore, the proximal portion ofthe surgical clip 50 (e.g., the hinge portion 56) may be receivedbetween the stabilizing members 126, 136 to reduce lateral movement orfish-tailing of the surgical clip 50. Each of the inner portions (e.g.,distally-facing apex) 128, 138 of the stabilizing members 126, 136 maylaterally overlap with the hinge portion 56 (as illustrated in FIG. 4)to reduce lateral movement or fish-tailing of the surgical clip 50. Thefirst leg member 52 of the surgical clip 50 may have a concave innersurface, a convex outer surface, and a hook member on a distal portion.The second leg member 54 may include convex inner surface, a concaveinner surface, and a tip member on a distal portion. As the surgicalclip 50 closes, the hook on the first leg member 52 may deflect aroundthe tip member on the second leg member to secure the surgical clip 50in a latched configuration. Due to the curvatures, the first and/orsecond leg members 52, 54 may straighten and/or elongate during theclosing and/or latching process. The clip applier 100 and/or thestabilizing members 126, 136 may not proximally abut the surgical clip50 to allow the surgical clip to straighten and/or elongate during theclosing and/or latching process.

The surgical clip 50 may be made of any suitable size and may be appliedto any number of tissues, such as blood vessels, lymph nodes, nerves,fallopian tubes, or cardiac tissue. The surgical clip 50 may beconstructed from any suitable biocompatible material, such as metals andpolymers. In some embodiments, the surgical clip 50 consists of aone-piece integral polymeric body formed from a suitable strongbiocompatible engineering plastic such as the type commonly used forsurgical implants. Exemplary materials include homopolymer or co-polymerpolyacetal, polyethylene terephthalate (PET), polybutylene terephthalate(PBT), polyoxymethylene, or other thermoplastic materials having similarproperties that can be injection-molded, extruded, or otherwiseprocessed into like articles. Exemplary embodiments and features of thesurgical clip 50 are further disclosed in U.S. Pat. No. 4,834,096, thedisclosure of which is incorporated herein by reference in its entirety.

As illustrated in FIGS. 6-9, the pivoting of the jaw assembly 102 may bebiased into the open configuration by at least one leaf spring 140 andactuated by longitudinal movement of the tubular member 114. The atleast one leaf spring 140 may have a distal end that overlaps with atleast one of the jaw members 110, 112. For example, the at least oneleaf spring 140 may include a pair leaf springs 140 on opposing lateralsides of a vertical beam or connector 142, and a proximal end of theleaf springs 140 may be fixed (e.g., welded) to the connector 142 in acantilever configuration. The leaf springs 140 may be on oppositevertical sides of the longitudinal axis of the clip applier 100. The jawmembers 110, 112 may each have a proximal portion including a pair ofproximal members 144. The proximal members 144 of each jaw member 110,112 may include a pair of legs that are separated from each other andstraddle a distal portion of the connector 142 for pivoting stability.The proximal members 144 may be pivotably secured to the connector 142with at least one pivot pin 146. Thus, the first jaw member 110 may besecured to the connector 142 with at least one first pivot pin 146, andthe second jaw member 112 may be secured to the connector 142 with atleast one second pivot pin 146. The first and second pivot pins 146 ofthe jaw members 110, 112 may be on opposing vertical sides of thelongitudinal axis of the connector 142. The connector 142 may be fixedlysecured in a lumen 108 of the shaft 104 and extend distally out of thetubular member 114. The proximal members 144 may have a width less thana distal length of the jaw members 110, 112, such that the proximalmembers 144 fit inside the tubular member 144 to be cammed into a closedconfiguration. The tubular member 144 further prevents the jaw members110, 112 from flexing in the closed configuration.

One of the proximal members 144 of each of the jaw members 110, 112 mayfurther include a proximal extension 148 proximal of the pivot pin 146and angled relative to the longitudinal axis of the clip applier 100.The proximal extensions 148 may be leg extensions extending from oneproximal member 144 further proximally than the opposing proximal member144 of the same jaw member 110, 112. The proximal extensions 148 of thefirst and second jaw members 110, 112 may laterally cross each other atthe longitudinal axis of the clip applier 100. Only one of the proximalmembers 144 of each jaw member 110, 112 may have a proximal extension148 to enable pivoting by the respective leaf spring 140 and preventinginterference by the opposing jaw member 110, 112. The proximal extension148 may extend from only one lateral side of the respective first andsecond jaw member 110, 112. Thus, the proximal extensions 148 of the jawmembers 110, 112 may extend on opposing lateral sides of the connector142. The proximal extensions 148 may include an upper surface 149 angledrelative to the longitudinal axis. The leaf springs 140 may overlap withor symmetrically lay radially on top of the angled surface of each ofthe proximal extension 148 of the jaw members 110, 112 in both of theopen configuration (FIG. 6) and closed configuration (FIG. 7) to biasthe jaw assembly 102 in the open configuration. Thus, the leaf springs140 may not be deflected (straight) or slightly deflected in the openconfiguration and be deflected or further deflected in the closedconfiguration due to the relative angle of the jaw members 110, 112. Thedeflection of the leaf springs 140 may symmetrically push the extensions148 of each of the jaw members 110, 112 in opposite directions withrespect to the longitudinal axis of the clip applier 100, to bias thejaw assembly 102 into the open configuration. The jaw members 110, 112may contact each other (e.g., at the proximal extensions 148, asillustrated in FIG. 6) to prevent further pivoting and to provide a stopin the open configuration.

The tubular member 114 may be actuated by longitudinal movement of anactuator 150. The actuator 150 may be an actuating shaft extendingthrough the lumen 108 of the shaft 104 and connected to the handleassembly 106. Squeezing or compressing of the second handle member 118relative to the first handle member 116 may cause longitudinaladvancement of the actuator 150 that causes longitudinal advancement ofthe tubular member 114 to cam the proximal members 144 of the jawassembly 102 into the closed configuration against the bias of the leafsprings 140. Release of the second handle member 118 may release thedistal force applied to the tubular member 114, such that the bias ofthe leaf springs 140 may open the jaw members 110, 112 to longitudinallyretract the tubular member 114. The tubular member 114 may have a distalportion 152 and a proximal portion 154, where the distal portion 152 hasa larger diameter than the proximal portion 154. The distal portion 152may extend distally of the shaft 104 and may have a diameter that issubstantially the same as the diameter of the shaft 104. Thus, theproximal end of the distal portion 152 may abut the distal portion ofthe shaft 104 when the jaw assembly 102 are in an open configuration (asillustrated in FIG. 6). The distal portion 152 may be configured toreceive the proximal portions 144 and to cam the first and second jawmembers 110, 112 to close the jaw assembly 102. Thus, the leaf springs140 may bias the jaw assembly 102 open by radially overlying theproximal extensions 148 proximal of the hinge pins 146, and the tubularmember 114 may close the jaw assembly 102 by camming a portion of thejaw members 110, 112 distal of the hinge pins 146.

The proximal portion 154 of the tubular member 114 may be slideablyreceived in the lumen 108 of the shaft 104. The proximal portion 154 maybe secured to the actuator 150 by receiving the actuator 150 in a lumenof the proximal portion 154 and/or mating one or more radial projectionsof the actuator 150 with one or more proximal slots in or on theproximal portion 154. The proximal portion 154 may receive the proximalend of the connector 142 in a distal opening and include an elongatedslot 160 along its length that receives a pin 162 on the connector 142.Longitudinal movement of the tubular member 114 relative to theconnector 142 may cause the pin 162 to slide longitudinally through theelongated slot 160. The pin 162 may be fixedly secured (e.g., welded) tothe shaft 104 to stabilize the connector 142. For example, the pin 162may extend through and be welded into an elongated slot 164 of the shaft104 that overlaps with the elongated slot 160 of the tubular member 114.The overlap of the elongated slots 160, 164 may allow visibility of therelative longitudinal position and/or movement of the tubular member 114during actuation of the jaw assembly 102.

The many features and advantages of the invention are apparent from thedetailed specification, and thus, it is intended by the appended claimsto cover all such features and advantages of the invention which fallwithin the true spirit and scope of the invention. Further, sincenumerous modifications and variations will readily occur to thoseskilled in the art, it is not desired to limit the invention to theexact construction and operation illustrated and described, andaccordingly, all suitable modifications and equivalents may be resortedto, falling within the scope of the invention.

What is claimed is:
 1. A clip applier configured to apply a surgicalclip, the clip applier comprising: a first jaw member and a second jawmember, the first jaw member being configured to pivot between an openconfiguration and a closed configuration; a leaf spring configured tobias the first jaw member into the open configuration; and a tubularmember configured to advance over the first jaw member to cam the firstjaw member into a closed configuration against the bias of the leafspring.
 2. The clip applier of claim 1, further comprising a second leafspring configured to bias the second jaw member into an openconfiguration, wherein the second jaw member is configured to pivotbetween the open configuration and a closed configuration, and thetubular member is configured to advance over the second jaw member tocam the second jaw member into the closed configuration against the biasof the second leaf spring.
 3. The clip applier of claim 2, wherein theleaf spring overlaps with a proximal portion of the first jaw member tobias the first jaw member into the open configuration, and the secondleaf spring overlaps with a proximal portion of the second jaw member tobias the second jaw member into the open configuration.
 4. The clipapplier of claim 1, wherein the proximal portion of each of the firstand second jaw members includes a proximal extension angled relative toa longitudinal axis of the clip applier.
 5. The clip applier of claim 4,wherein the proximal extension extends from only one lateral side of therespective first and second jaw member.
 6. The clip applier of claim 1,wherein the first jaw member and the second jaw member each have aproximal portion and a distal portion, the proximal portion having awidth less than the distal portion and configured to be received in thetubular member.
 7. The clip applier of claim 1, further comprising aconnector disposed in the tubular member, wherein the leaf spring andthe second leaf spring are disposed on opposite lateral sides of theconnector.
 8. The clip applier of claim 1, wherein a proximal portion ofthe leaf spring and a proximal portion of the second leaf spring arefixed to the connector.
 9. The clip applier of claim 1, wherein at leastone of the first jaw member and the second jaw member are pivotablycoupled to the connector.
 10. The clip applier of claim 1, wherein thefirst jaw member is pivotably coupled to the connector at a first pivotpin, and the second jaw member is pivotably coupled to the connector ata second pivot pin.
 11. The clip applier of claim 1, wherein theproximal portion of at least one of the first jaw member and the secondjaw member straddles a distal portion of the connector.
 12. The clipapplier of claim 1, wherein the tubular member comprises a distalportion and a proximal portion, the distal portion has a larger diameterthan the proximal portion, and the distal portion is configured to camthe first jaw member and second jaw member into the closedconfiguration.
 13. The clip applier of claim 1, wherein the connectorcomprises a pin, the tubular member comprises an elongated slot, and thepin travels through the elongated slot as the tubular member advances.14. The clip applier of claim 13, wherein the pin of the connector isfixed to a shaft receiving the tubular member.
 15. The clip applier ofclaim 1, further comprising: a shaft; a handle assembly on a proximalend of the shaft; and an actuator extending through the shaft andactuated by the handle assembly, wherein the actuator is configured toadvance through the shaft to advance the tubular member over the firstjaw member and the second jaw member.
 16. A clip applier configured toapply a surgical clip, the clip applier comprising: a first jaw memberand a second jaw member, each configured to pivot between an openconfiguration and a closed configuration; a first leaf springoverlapping a proximal portion of the first jaw member and configured tobias the first jaw member into the open configuration; a second leafspring overlapping a proximal portion of the second jaw member andconfigured to bias the second jaw member into the open configuration; atubular member configured to advance over the first jaw member and thesecond jaw member to cam the first jaw member and the second jaw memberinto the closed configuration against the bias of the first leaf springand the second leaf spring; a connector disposed in the tubular member,wherein the first leaf spring and the second leaf spring are disposed onopposite lateral sides of the connector; a shaft; and an actuatorextending through the shaft, wherein the actuator is configured toadvance through the shaft to advance the tubular member over the firstjaw member and the second jaw member.
 17. The clip applier of claim 16,wherein the first jaw member is pivotably coupled to the connector at afirst pivot pin, and the second jaw member is pivotably coupled to theconnector at a second pivot pin.
 18. The clip applier of claim 16,wherein the connector comprises a pin, the tubular member comprises anelongated slot, the pin travels through the elongated slot as thetubular member advances, and the pin is fixed to a shaft receiving thetubular member.
 19. The clip applier of claim 16, wherein the tubularmember comprises a distal portion and a proximal portion, the distalportion has a larger diameter than the proximal portion, and the distalportion is configured to cam the first jaw member and second jaw memberinto the closed configuration.
 20. The clip applier of claim 16, furthercomprising: a shaft; a handle assembly on a proximal end of the shaft;and an actuator extending through the shaft and actuated by the handleassembly, wherein the actuator is configured to advance through theshaft to advance the tubular member over the first jaw member and thesecond jaw member.